'Epidemic' diuretic overuse is harming seniors, researcher says

Diuretics are widely prescribed for conditions affecting the elderly without proper consideration of the drugs' side effects, according to recently published research.

Writing in the current issue of JAMDA, Martin Wehling, M.D., coined the term “morbus diureticus” to describe what he calls the "syndrome" of inappropriate diuretic prescribing. There is an “epidemic overuse” of these drugs for conditions such as arterial hypertension, heart failure and renal disease, he argued.

Among the diuretic side effects that have “particular relevance” for seniors, Wehling named electrolyte disturbances such as hypokalemia and hyponatremia. Hypokalemia is associated with sudden death related to cardiac arrhythmia, and hyponatremia can damage the brain. Diuretic overdose is “common” among heart failure patients, according to Wehling. Diuretics known as thiazides are associated with diabetes onset.

In addition to eroding the health of residents, inappropriate diuretic prescribing could undermine providers' efforts to reduce hospitalizations. Diuretics rank among the five leading drug classes associated with hospitalizations for adverse reactions, according to Wehling.

Clinicians should institute a number of practices to diagnose inappropriate administration of diuretics, Wehling proposed.